Intestinal Expression of TLR Gene Changes Early After Gastric Bypass and Association With Type 2 Diabetes Remission

Abstract Abnormal activation of toll-like receptors (TLRs) is observed in rodents with obesity and is correlated with local dysbiosis and increased gut permeability. These purported changes trigger the systemic inflammation associated with obesity-related comorbidities, including type 2 diabetes mellitus (T2D). Roux-en-Y gastric bypass (RYGB) is an effective treatment for severe obesity and is known to induce changes in the gut microbiota and to decrease systemic inflammation in humans. This study examined the intestinal expression of TLR-encoding genes in women (n=20) with obesity treated with RYGB and the relationship of these genes to T2D remission (T2Dr). Intestinal biopsies were performed before and 3-months after RYGB. Partial and complete T2Dr after one year was assessed using American Diabetes Association criteria. Affymetrix Human GeneChip 1.0 ST array (microarray) and TaqMan assay (RT-qPCR) were used to analyze intestinal gene expression; associations with systemic markers of energy homeostasis were examined. Patients experienced significant weight loss (P